Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1194299628 |
---|---|
Provider Name | Alison Miranda |
First Address | Swansea, MA 02777-2163 |
Second Address | Swansea, MA 02777-2163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2019 |
Last Update Date | 17/01/2019 |